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What is Medicare Part D

Prior to Medicare drug coverage, most seniors had to find prescription coverage through a confusing web of private insurance companies. Now there is a single source for prescription drug coverage. Although administered by private insurers, the plans offer a nice range of coverage for a reasonable cost. Adler Insurance brings you these tips to assist you with your medicare Part D plan searching.

 

Many Plans, One Complicated Choice

Medicare encourages competitive pricing among the private insurance companies that provide Part D coverage. This approach translates to affordable plans from household names like Humana, Aetna Medicare and Silver

script. However, it can also result in confusion for seniors as they try to pick out the best plan from a seemingly endless list.

Raising the stakes is the fact that plan enrollment runs from October 15 to December 7, with no way to opt out. Once the choice is made, one is stuck with it, for better or worse, until that date. Also, enrollees who fail to meet certain deadlines could face a financial penalty.

Given the complexity of Part D, seniors are well-advised to educate themselves before making a decision. At Adler Insurance we are happy to help you choose the right plan for your needs.

 

Making Sense of Drug Costs

Prescription drugs covered by Part D are divided into four price levels called tiers, with Tier 1 being the lowest and Tier 4 the highest. Some plans may only have three Tiers. Generics and inexpensive drugs are low-tier drugs; brand-name and costly drugs carry higher tier numbers.  Lack of consistency among Part D plans means that tier designations further complicate plan selection. For example, a certain drug might be labeled Tier 2 on one plan and Tier 3 on another, yet cost less under the second plan. As a general rule, tier rankings and exclusions should not dictate plan choice. The best plan is usually the one with the lowest monthly premium, deductible and prescription costs, plain and simple.

 

Controlling Drug Costs

Therapeutic Interchange, or "TI" as it's called in the healthcare industry, is the process of finding medications that are similar in function to the ones you are taking. Most of the time, this is done to handle some sort of allergic reaction or side effect that is caused by taking the original drug.

However, this can be used to find lower cost medications in the same class as the medications you are taking. For example the retail price of a medication  can be up to $200 per month while a therapeutic alternative, has almost identical function to the original drug but costs only $15 or less per month.

 

Special Assistance

For seniors who have difficulty meeting the costs of Part D, a federal financial aid program called Special Assistance is available to help. Eligible seniors may receive subsidies on monthly premiums and drug costs, or have all expenses paid for them. Recipients of state Medicaid benefits are also entitled to Part D subsidies, and most nursing home residents over age 65 are fully exempt from all prescription costs.

In conclusion Medicare Part D is an important program that provides essential prescription drug benefits for America's senior citizens. Although the plan can be confusing, education is key to understanding the plan details and how to make them work best for the individual. Seniors should makes note of the deadlines required by the plans, and work one-on-one with their Insurance agent to customize their benefit.

At Adler Insurance in Prescott, we are happy to help you find the right Medicare part D plan to fit your needs. Contact us today 928-710-1455

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